Far too many women suffer from chronic breast boils and/or abscesses, and find them so embarrassing that they try to treat this painful condition without seeking medical help. While you can self-treat the occasional "pimple" around or under your breast, severe and chronic infections demand a doctor’s care.
Remember those teenage years, when every pimple was a crisis? Something you anguished about, hid with Cover Girl, and worked to prevent with various overpriced skin cleansers?
Fortunately, those embarrassing days eventually pass - for most of us.
But for some, the problem appears in a new, and potentially even more embarrassing area:
And it’s much more serious.
Hidradenitis suppurativa is an acne-related skin condition that can manifest as chronic infections (boils) or abscesses around and on the breast - particularly in the crease underneath. Not only is this condition painful and potentially embarrassing; it can be chronic, reappearing again and again despite its sufferer’s best attempts to treat it.
Lesions can appear in clusters; or as single eruptions ranging in size from a pea to a golf ball. Treatment, as well as the natural course of the infection, often leaves scars. And, while a woman’s breasts aren’t displayed for the whole world to see like her teenage face was, dating and any kind of intimacy can become an emotional nightmare.
What causes HS?
Basically, plugged apocrine (sweat) glands and/or hair follicles trigger inflammation, pain, swelling, and the formation of pus. This is especially likely to happen in areas of the body subject to heat buildup, and thus the site of more sweat glands: your underarms, groin, buttocks, and the area under your breasts, particularly if you’re large-breasted.
HS isn’t the result of poor personal hygiene; nor is it caused by being overweight (though both of these factors can make it worse). While little is known about exact causes, researchers theorize it may have a genetic element (certain ethnic groups are more prone to it); and it might be related to the spectrum of autoimmune diseases.
What triggers an HS attack?
If you’re subject to chronic boils and have been diagnosed with HS, the following factors can trigger an episode:
- Wearing tight clothing and/or non-breathable fabrics;
- Hot, humid weather;
- Using oral contraceptives;
- Hormones: women seem to be prone to episodes right before their period, and post-pregnancy.
How can you treat HS at home?
Severe attacks of HS require a doctor’s care. In cases where the lesions become too painful, they may need to be lanced - something you should NEVER attempt on your own. In addition, your doctor may prescribe a course of antibiotics, to try to stop the attack from spreading. Small and localized flareups, however, can be dealt with as follows:
- Keep the area under your breasts as cool and dry as possible. Wear a cotton bra when dressed; in private, try to expose the area to air whenever possible.
- Wash regularly with a hexachlorophene-based anti-bacterial soap (Phisohex, for example).
- Apply warm, moist compresses (e.g., a clean washcloth dipped in hot water and wrung out); this may help reduce swelling.
- Take an anti-inflammatory painkiller (e.g., Advil), to reduce discomfort.
And remember: HS is NOT your fault It’s not caused by being overweight, or having large breasts, or not showering often enough. You didn’t do anything to deserve this; and you shouldn’t be embarrassed to seek medical help. Together, you and your doctor can treat HS, and hopefully drive it into long (perhaps permanent) periods of remission.
Finally, HS nearly always disappears after menopause; so if nothing else, there’s hope for the future.
PJ Hamel is senior digital content editor and food writer at King Arthur Flour, and a James Beard award-winning author. A 16-year breast cancer survivor, her passion is helping women through this devastating disease. She manages a large and active online survivor support network based at her local hospital and shares her wisdom and experience with the greater community via HealthCentral.com.